Provider Demographics
NPI:1336302488
Name:COWDRILL, LORETTA M (NP)
Entity Type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:M
Last Name:COWDRILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:LORETTA
Other - Middle Name:M
Other - Last Name:BECKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:8001 FORBES PL
Mailing Address - Street 2:#200
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-2208
Mailing Address - Country:US
Mailing Address - Phone:703-321-8860
Mailing Address - Fax:703-221-8381
Practice Address - Street 1:8001 FORBES PL
Practice Address - Street 2:#200
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-2208
Practice Address - Country:US
Practice Address - Phone:703-321-8860
Practice Address - Fax:703-221-8381
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024069386363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health